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Gabapentin versus pregabalin in relieving early post-surgical neuropathic pain in patients after lumbar disc herniation surgery: a prospective clinical trial.

Abstract

OBJECTIVES

The roles of gabapentin and pregabalin are well established in the management of chronic neuropathic pain. Here, we investigated the effectiveness of pregabalin and gabapentin for treating acute neuropathic pain following lumbar discectomy.

METHODS

This prospective, non-randomized, and observational study included 54 patients who experienced acute neuropathic pain after lumbar discectomy. The assessments included the Leeds assessment of neuropathic symptoms and signs scale (LANSS), the Oswestry disability index (ODI), and the visual analog scale (VAS) pre-operatively and at 3 days, 6 months, and 1 year after surgery. The LANSS scores ≧12 suggest the presence of neuropathic pain. Those patients who reported neuropathic pain were randomly treated with gabapentin or pregabalin.

RESULTS

In the gabapentin group, the LANSS scores increased to 14 at 3 days after surgery. The patients improved neurologically and on the LANSS, which decreased to 10 points 6 months after surgery and to 4 points at 1 year (P < 0.001). In the pregabalin group, the LANSS scores increased from 12 to 16 points on post-operative day 3 and then decreased to 12 and 5 at the 6-month and 1-year follow-ups, respectively (both P < 0.001). The ODI and VAS scores significantly improved in both groups (P < 0.001).

DISCUSSION

Many patients may suffer from neuropathic pain in the early post-surgical period after lumbar discectomy. Gabapentin and pregabalin are anticonvulsant agents that may decrease perioperative central sensitization and early post-surgical neuropathic pain. Gabapentin and pregabalin effectively relieved neuropathic pain and prevented the conversion of acute pain to chronic pain at the 1-year follow-up after lumbar discectomy.

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    Source

    Neurological research 36:12 2014 Dec pg 1080-5

    MeSH

    Adult
    Aged
    Amines
    Analgesics
    Cyclohexanecarboxylic Acids
    Diskectomy
    Female
    Follow-Up Studies
    Gabapentin
    Humans
    Intervertebral Disc Displacement
    Lumbar Vertebrae
    Male
    Middle Aged
    Neuralgia
    Pain Measurement
    Pregabalin
    Prospective Studies
    Treatment Outcome
    gamma-Aminobutyric Acid

    Pub Type(s)

    Clinical Trial
    Journal Article

    Language

    eng

    PubMed ID

    24938318

    Citation

    Dolgun, Habibullah, et al. "Gabapentin Versus Pregabalin in Relieving Early Post-surgical Neuropathic Pain in Patients After Lumbar Disc Herniation Surgery: a Prospective Clinical Trial." Neurological Research, vol. 36, no. 12, 2014, pp. 1080-5.
    Dolgun H, Turkoglu E, Kertmen H, et al. Gabapentin versus pregabalin in relieving early post-surgical neuropathic pain in patients after lumbar disc herniation surgery: a prospective clinical trial. Neurol Res. 2014;36(12):1080-5.
    Dolgun, H., Turkoglu, E., Kertmen, H., Gurer, B., Yilmaz, E. R., Comoglu, S. S., & Sekerci, Z. (2014). Gabapentin versus pregabalin in relieving early post-surgical neuropathic pain in patients after lumbar disc herniation surgery: a prospective clinical trial. Neurological Research, 36(12), pp. 1080-5. doi:10.1179/1743132814Y.0000000404.
    Dolgun H, et al. Gabapentin Versus Pregabalin in Relieving Early Post-surgical Neuropathic Pain in Patients After Lumbar Disc Herniation Surgery: a Prospective Clinical Trial. Neurol Res. 2014;36(12):1080-5. PubMed PMID: 24938318.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gabapentin versus pregabalin in relieving early post-surgical neuropathic pain in patients after lumbar disc herniation surgery: a prospective clinical trial. AU - Dolgun,Habibullah, AU - Turkoglu,Erhan, AU - Kertmen,Hayri, AU - Gurer,Bora, AU - Yilmaz,Erdal R, AU - Comoglu,Selim S, AU - Sekerci,Zeki, Y1 - 2014/06/18/ PY - 2014/6/19/entrez PY - 2014/6/19/pubmed PY - 2015/6/11/medline KW - Gabapentin, KW - Lumbar disc herniation, KW - Lumbar discectomy, KW - Neuropathic pain, KW - Pregabalin, KW - Treatment SP - 1080 EP - 5 JF - Neurological research JO - Neurol. Res. VL - 36 IS - 12 N2 - OBJECTIVES: The roles of gabapentin and pregabalin are well established in the management of chronic neuropathic pain. Here, we investigated the effectiveness of pregabalin and gabapentin for treating acute neuropathic pain following lumbar discectomy. METHODS: This prospective, non-randomized, and observational study included 54 patients who experienced acute neuropathic pain after lumbar discectomy. The assessments included the Leeds assessment of neuropathic symptoms and signs scale (LANSS), the Oswestry disability index (ODI), and the visual analog scale (VAS) pre-operatively and at 3 days, 6 months, and 1 year after surgery. The LANSS scores ≧12 suggest the presence of neuropathic pain. Those patients who reported neuropathic pain were randomly treated with gabapentin or pregabalin. RESULTS: In the gabapentin group, the LANSS scores increased to 14 at 3 days after surgery. The patients improved neurologically and on the LANSS, which decreased to 10 points 6 months after surgery and to 4 points at 1 year (P < 0.001). In the pregabalin group, the LANSS scores increased from 12 to 16 points on post-operative day 3 and then decreased to 12 and 5 at the 6-month and 1-year follow-ups, respectively (both P < 0.001). The ODI and VAS scores significantly improved in both groups (P < 0.001). DISCUSSION: Many patients may suffer from neuropathic pain in the early post-surgical period after lumbar discectomy. Gabapentin and pregabalin are anticonvulsant agents that may decrease perioperative central sensitization and early post-surgical neuropathic pain. Gabapentin and pregabalin effectively relieved neuropathic pain and prevented the conversion of acute pain to chronic pain at the 1-year follow-up after lumbar discectomy. SN - 1743-1328 UR - https://www.unboundmedicine.com/medline/citation/24938318/Gabapentin_versus_pregabalin_in_relieving_early_post_surgical_neuropathic_pain_in_patients_after_lumbar_disc_herniation_surgery:_a_prospective_clinical_trial_ L2 - http://www.tandfonline.com/doi/full/10.1179/1743132814Y.0000000404 DB - PRIME DP - Unbound Medicine ER -